A doctor who prescribes weight loss drugs to his patients says he's also lost 25lbs with a new drug.
He takes a version of the drug Ozempic, called semaglutide, in the form of a shot each week.
He plans to keep taking it for at least six more months to try and keep the weight off for good.
This is an as-told-to essay based on a conversation with a 41-year-old doctor working in the Midwest. Insider verified his identity, medical license, and weight loss data. It has been edited for length and clarity.
When I was 9 years old, my teacher brought in a scale and weighed every kid in class.
That was probably one of the first times I can remember knowing that I was overweight.
I tried everything over the years. Long hours at the gym. Karate. Keto. Gluten free. Meal replacements. Portion counting. The diabetes drug metformin, which has been used off-label for weight-loss.
Some of these things worked well, for a while. I'd lose 10, 20, or 30 pounds, but then the weight would come creeping back.
People say that "calories in, calories out" is an easy way to think about how to control your weight, but I don't think that's true. I think there's more going on in the equation — our modern food system and the chemicals we consume in our food are probably having some effect. And then there are likely other factors, like genetic differences regulating metabolism and appetite or food sensitivities that keep some brothers and sisters in families lean while others, like me, are distracted by thoughts of food and snacking.
I've known about the new class of injectable, GLP-1 diabetes and obesity drugs for a while now. I remember when liraglutide was first approved for weight loss in 2014. I'd even prescribed it to a few patients over the years.
But it was only more recently that hormone pens like Wegovy and Ozempic became available as once a week weight loss treatments instead of once a day needle sticks. That made it feel more like something I could try out at home. So, about a year ago I started taking a small dose of semaglutide, a form of Ozempic.
This is 'what it's like to have a normal response to eating food'
Something remarkable happened about a day and a half after I injected that first dose of semaglutide. Satisfaction.
It was a routine dinner at home with my family. I can't even remember what we ate that night. It was probably something my wife had cooked many times before. But I can distinctly remember putting the last forkful of food in my mouth, and feeling completely satiated. Not overstuffed, not craving more.
I thought to myself, "This must be what it's like to have a normal response to eating food."
To be clear, I don't know how much of that feeling was the placebo effect, and the excitement and hope I felt trying a new treatment that I thought might actually work — but I do know it was a special moment in my life.
Semaglutide is known to increase satiety, slow down digestion, and send hormone-like signals to your brain, telling you that you're full when you've eaten. I also wonder if it's possible the drug might be impacting my metabolism in other nuanced ways. There's some research suggesting GLP-1s can improve healthy fat levels in mice, and I wonder if they also help people turn more of the calories we eat into warmth, instead of pudge.
I've lost about 25 pounds in 1 year, including some dangerous belly fat
During my time on semaglutide, I've lost about 25 pounds, including 1.25 pounds of the dangerous belly fat called visceral fat, which puts people at risk for all kinds of major health issues. That feeling of early satiety I experienced at the dinner table has stayed with me, too. It feels like my new normal when I eat.
To be honest, I still feel like I could lose a little more weight, maybe another 10 or 20 pounds, but I think I'd have to sacrifice a lot of time with family and friends — essentially never eating socially. I've tried higher doses of both semaglutide and another similar drug called Mounjaro, but they made me feel ill. At one point, on my highest dosage, I basically lost interest in eating altogether, which didn't feel healthy or helpful.
Today, I use a treadmill desk for a few hours every day while at the computer. I know some doctors have worried that semaglutide can contribute to significant muscle mass loss in some patients, but I'm happy to report that body scans show I haven't lost much of my muscle on semaglutide — most of the extra weight I've discarded so far has been fat. I wonder if this is because of my diet. I've always tried to eat healthy, consuming lots of vegetables, proteins, nuts and seeds, habits I learned first from my nutritionist mom as a kid.
I have a hunch that going off semaglutide slowly is important
There's been a lot of talk about how once people stop using these injectable weight loss drugs, their old hunger comes roaring back with a vengeance. A large study of hundreds of adults across the US, UK and other countries showed patients regaining more than 60% of their weight after a year off of semaglutide. But I have a hunch that maybe people might need to more delicately taper their Ozempic dosages instead of quitting cold turkey.
I've been on a low, 0.5mg dose of semaglutide for about six months now, and I plan to stay on it for at least six more. I wonder if taking more time discontinuing like this — staying on the lowest effective dose for months and months — might give my body more time to re-set its internal thermostat, which I think has been out of whack for more than 30 years. It's just a theory, for now, but I'd love to see large trials of GLP-1 users test this idea of maintenance doses out more precisely.
We still have no idea what the long term effects of these medications may be. In five years, will I wake up one day and discover I'm immune to semaglutide, and my old appetite and metabolism has returned? There's no way to rule that out.
But, I'm happy for now knowing that I'm healthier than I was a year ago. And to all the people out there who think weight loss is just a matter of willpower, or eating right, including the doctors who say fat loss is a simple 'eat less, move more' binary, I offer my story as a testimony.
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